Bolton Paul, Michalopoulos Lynn, Ahmed Ahmed Mohammed Amin, Murray Laura K, Bass Judith
Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, MD, USA.
Torture. 2013;23(1):1-14.
From 1986-9, the Kurdish population of Iraqi Kurdistan was subjected to an intense campaign of military action, and genocide by the central Iraq government. This campaign, referred to as the Anfal, included systematic attacks consisting of aerial bombings, mass deportation, imprisonment, torture, and chemical warfare. It has been estimated that around 200,000 Kurdish people disappeared.
To gain a better understanding of current priority mental health and psychosocial problems among Kurdish survivors of the Anfal, and to inform the subsequent design of culturally appropriate and relevant assessment instruments and services to address these problems. The study examined 1) the nature and cause of current problems of survivors of torture and/or civilian attacks and their families, 2) what survivors do to address these problems, and 3) what they felt should be done.
We used a grounded theory approach. Free list interviews with a convenience sample (n=42) explored the current problems of Kurdish persons affected by torture. Subsequent key informant interviews (n=21) gathered more detailed information on the priority mental health problem areas identified in the free list interviews.
Major mental health problem areas emerging from the free list interviews (and explored in the key informant interviews) included 1) problems directly related to the torture, 2) problems related to the current situation, and 3) problems related to the perception and treatment by others in the community. Problems were similar, but not identical, to Western concepts of depression, anxiety, PTSD and related trauma, and traumatic grief.
Iraqi Kurdish torture survivors in Iraq have many mental health and psychosocial problems found among torture survivors elsewhere. The findings suggest that the problems are a result of the trauma experienced as well as current stressors. Development of mental health assessment tools and interventions should therefore address both previous trauma and current stressors.
1986年至1989年期间，伊拉克库尔德斯坦地区的库尔德人遭受了伊拉克中央政府发起的一场激烈军事行动及种族灭绝行径。这场被称为“安法尔”的行动包括一系列有组织的袭击，如空袭、大规模驱逐、监禁、酷刑以及化学战。据估计，约20万库尔德人失踪。
为了更深入了解“安法尔”事件库尔德幸存者当前的心理健康和心理社会问题重点，并为后续设计适合该文化背景且相关的评估工具及服务以解决这些问题提供依据。该研究考察了：1）遭受酷刑和/或平民袭击的幸存者及其家人当前问题的性质和成因；2）幸存者为解决这些问题所采取的措施；3）他们认为应该采取的措施。
我们采用了扎根理论方法。对一个便利样本（n = 42）进行自由列举访谈，以探究受酷刑影响的库尔德人的当前问题。随后对关键知情者进行访谈（n = 21），以收集关于自由列举访谈中确定的心理健康问题重点领域的更详细信息。
自由列举访谈中出现（并在关键知情者访谈中进一步探究）的主要心理健康问题领域包括：1）与酷刑直接相关的问题；2）与当前状况相关的问题；3）与社区中他人的看法及对待方式相关的问题。这些问题与西方对抑郁、焦虑、创伤后应激障碍及相关创伤以及创伤性悲伤的概念有相似之处，但并不完全相同。
伊拉克境内的库尔德酷刑幸存者存在许多其他地方酷刑幸存者身上常见的心理健康和心理社会问题。研究结果表明，这些问题是过去经历的创伤以及当前压力源共同作用的结果。因此，心理健康评估工具和干预措施的开发应同时关注既往创伤和当前压力源。
